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A direct route to health care

MFCC joins budding city-wide co-operative health care network

MULTNOMAH - As a means of making health care accessible to all, the Multnomah Family Care Center is offering patients the option to receive care directly from its doctors instead of via insurance companies.

The clinic is one of a growing network of providers to do so as part of a city-wide, co-operative nonprofit organization.

Patient/Physician Cooperatives (PPC), which has previously worked in Houston, Texas, and in North Carolina, is designed to offer health care at an affordable price while keeping the patients' interests at heart. It began its Portland operations in summer 2011.

Its management is headed mainly by volunteers involved in a grassroots effort to change the status quo of health care in the United States.

'For me, it's not about politics, it's just about giving patients resources to come in and not wait until they are really sick,' MFCC's Kirsten Carr, M.D., said.

MFCC's doctors joined PPC at the end of 2011, beginning with its acupuncturist; Carr is one of two M.D. providers in the co-op.

MFCC's staff also includes a chiropractor, a naturopath and two massage therapists.

City-wide, PPC comprises other naturopathic and holistic providers and two nurse practitioners.

She said the co-op already has vision and mental health providers, but she hopes it will soon add others such as midwives as well. Patients pay a one-time enrollment fee to join PPC and then pay monthly membership and primary care provider fees, which combined average less than $60 a month - a set up that could work well for people who don't qualify for state assistance but can't pay their insurance premiums; for people who are working without insurance available through their employer; or for those with high insurance deductibles, Carr said.

Whether he or she is 'a millionaire or someone living on the street,' Carr said everyone is eligible to join PPC, and the group does not screen for pre-existing conditions.

The co-op acts as a collection service, so patients are not charged during their medical visits.

Patients have the option of contracting with a primary care provider from the PPC network or receiving care from multiple PPC members; fees are adjusted based on their choices. At MFCC, co-op patients can meet with one of its doctors or mix and match.

Along with patients insured through standard plans, Carr said she personally has about 15 co-op patients, and the clinic has five or six who see more than one of its doctors. She said someone new signs up for PPC at least weekly.

In most cases, co-op members are charged less at MFCC than they would be at walk-in clinics, and Carr said the goal of the co-op is establishing preventative care for patients, so they won't have to turn to emergency rooms when they get sick.

Because the co-op format allows doctors to develop relationships with their patients and learn their medical histories, Carr said the system works well at the neighborhood-oriented MFCC.

The clinic itself features pieces from local artists on its walls and runs ongoing health groups such as nutrition classes and running support groups to engage community members.

'I (think) of myself as a 'small town doctor in big city,' in keeping with neighborhood,' Carr said.